A Covid-19 infection may cause blood vessels to age by as much as five years, particularly in women, according to new research published on 18th August in the European Heart Journal.
Blood Vessel Ageing and Cardiovascular Risk
Blood vessels naturally stiffen with age, but the study suggests that Covid accelerates this process. Stiffer arteries raise the risk of cardiovascular problems, including heart attack and stroke.
Professor Rosa Maria Bruno from Université Paris Cité, France, who led the study, explained:
“Since the pandemic, we have seen that many people live with long-lasting symptoms after Covid. What remains unclear is the exact process in the body that causes these symptoms. Because Covid can directly affect blood vessels, we believe it triggers early vascular ageing. This means blood vessels become older than a person’s actual age, which increases vulnerability to heart disease. Identifying those at risk early is crucial to prevent serious outcomes such as heart attacks and strokes.”
Study Design and Participants
The CARTESIAN study recruited 2,390 participants from 16 countries, including Austria, Australia, Brazil, Canada, Cyprus, France, Greece, Italy, Mexico, Norway, Turkey, the UK and the US. Recruitment ran between September 2020 and February 2022.
Researchers divided participants into four groups:
- Those who never had Covid,
- Those who recovered from Covid without hospitalisation,
- Those hospitalised in a general ward, and
- Those treated in intensive care.
Measuring Vascular Age
Researchers assessed vascular age using carotid-femoral pulse wave velocity (PWV), a measure of how quickly blood pressure waves travel from the neck to the legs. Higher PWV indicates stiffer arteries. Measurements were taken at six months and 12 months post-infection.
Alongside these tests, researchers recorded demographic factors such as age, sex, and cardiovascular risk markers.
Key Findings: Women Show Greater Impact
After adjusting for other health factors, the study revealed that all Covid-infected groups, even those with mild illness, had stiffer arteries compared with people who never had Covid.
The effect appeared stronger in women and in individuals experiencing long Covid symptoms such as fatigue and shortness of breath.
- Women with mild Covid showed an average PWV increase of 0.55 m/s,
- Women hospitalised with Covid showed an increase of 0.60 m/s, and
- Women in intensive care recorded the largest increase at 1.09 m/s.
Researchers highlighted that even an increase of 0.5 m/s is “clinically relevant,” equivalent to about five years of vascular ageing and a 3% higher cardiovascular risk in a 60-year-old woman.
Vaccination and Long-Term Outlook
As reported by the European Society of Cardiology, the findings also showed that vaccinated individuals generally had less stiff arteries than unvaccinated participants. Over time, vascular ageing linked to Covid appeared to stabilise or slightly improve.
Professor Bruno noted: “Covid-19 acts on ACE2 receptors lining the blood vessels. By entering through these receptors, the virus can cause vascular dysfunction. The immune and inflammatory responses further contribute to this effect. Women may be more vulnerable because their immune systems mount stronger responses, which can unintentionally increase vascular damage after infection.”
Prevention and Treatment Possibilities
Fortunately, vascular ageing is measurable and manageable. Common treatments include lifestyle modifications, blood pressure medication, and cholesterol-lowering drugs. Professor Bruno stressed the importance of reducing cardiovascular risks in individuals showing accelerated vascular ageing.
The research team plans to follow participants further to determine whether this early vascular ageing translates into higher rates of heart attack and stroke.
Expert Commentary
In an accompanying editorial, Dr Behnood Bikdeli from Harvard Medical School and colleagues wrote:
“While the acute threat of Covid-19 has diminished, its aftermath has introduced new challenges. Post-acute Covid syndrome—defined as symptoms lasting beyond three months—affects up to 40% of survivors. This multicentre study clearly shows persistent arterial stiffness after Covid, particularly in women.”
They concluded: “The CARTESIAN study demonstrates that Covid has aged our arteries, especially among women. The pressing question now is whether we can identify modifiable targets to prevent this process and reduce the long-term cardiovascular consequences.”